2. INTRODUCTION
• Eating disorder is characteristic by
abnormal eating habits that may involve
either insufficient or excessive food
intake to the determent of an individual’s
physical and emotional health.
3. • Eating is a normal social activity but
sometime may individual following
eating habits and food pattern by
abnormal way which might be caused
some complications in their future life.
4. INCIDENCE:
• The incidence and prevalence of eating
disorders depends as always on the definition
used and the population being considered. The
peak incidence of Anorexia Nervosa is around
the age of 18.
• For the bulimia nervosa is slightly higher.
5. affects all the
• Eating disorder
socioeconomic levels.
• Anorexia nervosa has the highest
mortality rate of any psychiatric disorder.
• The mortality rate for anorexia nervosa is
4% and bulimia nervosa is 3.9%.
6. ANOREXIA NERVOSA
Anorexia is syndrome characterized by
three essential criteria.
• The first is to self-induced starvation, to
a significant degree.
• The second is relentless drive for thinner
or morbid fear of fatness.
• The third is presence of medical signs
and symptoms resulting from starvation.
7. • Anorexia Nervosa is often associated
with disturbance of body images, the
perception that one is distressingly large
despite obvious thinners.
8. DEFINITION
• Anorexia Nervosa is an eating disorder
occurs most often in adolescent girls. The
problem is found as refusal of food to
maintain normal body weight by reducing
food intake, especially fats and
carbohydrates.
9. Types of Anorexia
1. Binge / Purge Type
• The individual suffering from anorexia
nervosa binge / purge type will purge
when he or she eats.
10. • This is typically a result of the
overwhelming feelings of guilt a sufferer
would experience in relation to eating;
they compensate by vomiting, abusing
laxatives, or excessively exercising.
11. • 2. Restrictive Anorexia
• In this form of anorexia nervosa, the
individual will fiercely limit the quantity
of food consumed, characteristically
ingesting a minimal amount that is well
below their body’s caloric needs,
effectively slowly starving him or herself.
12. ETIOLOGY
• The main etiological factors are,
• Biological,
• Social and
• Psychological factors are complicated
in the cause of anorexia nervosa.
14. • Feeling increased concern or attention to
weight and shape.
• Having family history of addictions or
eating disorder.
• Having negative self-image.
15. Signs and Symptoms
Missing meals
Eating very little or avoid eating any foods
that is fattening
Lying about what and when eaten and
weight
Taking medicine to reduce hunger (appetite
suppressants), such as slimming or diet pills
16. Signs and Symptoms
Exercising excessively,
Making oneself sick, or using laxatives or
diuretics
Overwhelming fear of gaining weight
Strict rituals around eating
Seeing losing a lot of weight as a positive
thing
Believing being fat
Not admitting weight loss is serious
17. Signs and Symptoms
Low body mass index (BMI)
Menstrual cycle stopping or not starting
Constipation
Abdominal pain
Headaches
Sleep disturbance
Feeling cold, dizzy or very tired
Dry skin
Hair loss from the scalp, or fine downy hair
Reduced sex drive
18. COMPLICATION
• Bradycardia, hypotension,
• ECG abnormalities, myocarditis.
• Hypoglycemia, imbalance of LH
• Anemia, leucopenia
• Esophagitis, dehydration, alkalosis
• P.S. Anorexia patients might sometimes suffer from depression
or anxiety
19. EXAMINATION AND TESTS
• Complete physical examination
including laboratory tests to rule out the
endocrine, metabolic and central nerves
system abnormality or other disorders.
22. TREATMENT
• The goals of treatment are to first restore
normal body Weight and eating habits
and then to address psychological issue.
• A Hospital stay may be needed if ;
23. • The person has lost a lot of Weight
(Below 30% of ideal body Wright).
• Weight loss continues despite treatment.
24. • Medical complications such as heart rate
problems, changes mental status and low
potassium levels.
• The person has severe depression or
thinks about committing suicide.
25. • Short term management aimed to ensure
weight gain and correct nutritional
deficiencies.
• Long term treatment aimed to
maintaining a normal weight achieved
through a short term management
26. Other treatments may include
• Antidepressant therapy
• Behavioral therapy
• Psychotherapy
• Supportive care
• Cognitive behavioral therapy (CBT)
27. Bulimia Nervosa
Bulimia nervosa is an eating disorder,
commonly referred to simply as bulimia.
It’s a serious condition that can be life-
threatening.
28. • Bulimia is an illness in which person
binges on food or has regular episodes of
significant over eating and feels a loss of
control.
• The affected person then uses various
methods such as vomiting or Laxative
abuse to prevent Weight gain.
29. • People with bulimia tend to show signs of
depression, anxiety, or obsessive-compulsive
disorders.
• Bulimia may cause moodiness and irritability.
abuse
• Feelings of embarrassment and shame.
• They’re also at risk for substance
problems and suicidal behavior.
30. Major Types of Bulimia
• Bulimia Nervosa Purging type –
This type of bulimia nervosa accounts
for the majority of cases of those suffering
from this eating disorder.
31. • In this form, individuals will regularly
engage in self-induced vomiting or abuse
of laxatives, diuretics, or enemas after a
period of bingeing.
32. • Bulimia Nervosa Non-purging type –
In this form of bulimia nervosa, the
individual will use other inappropriate
methods of compensation for binge
episodes, such as excessive exercising or
fasting.
33. 1. Cultural aspects
2. Families:
If you are having mother or sister with
bulimia you are more likely to have bulimia.
3. Life changing or stressful events:
Traumatic events as well as stressful things can
grad to bulimia.
Causes
34. 4. Personality traits:
• A person with bulimia may not like
herself. She hates the way she looks or
feels hopeless.
• She may be very moody have problems
expressing anger.
35. 5. Biology:
• Genes, Hormones or chemicals in brain
may be factors in developing bulimia.
36. SYMPTOMS:-
• Binges regularly. (Eats large amount of
food over short period) and purges of
time regularly.
• Diet and exercises often but maintains or
regains Wright.
37. • Becomes secret rater.
• Has swollen neck glands.
• Has scars on the back of hands from
forced vomiting
38. • Electrolyte imbalances, which can result
in cardiac arrhythmia, cardiac arrest,
• Chronic dehydration
• Inflammation of the esophagus
39. DIAGNOSIS
the upper
• Medical evaluation to rule out
gastro-intestinal disorder.
• MSE
• History.
• Lab test ( Hb% level, blood glucose, and
baseline ECG)
40. PSYCHOTHERAPY:
1) Cognitive Behavioral Therapy
• Cognitive Behavioral Therapy should be
considered benchmark.
• First line treatment of bulimia nervosa.
42. Binge-eating disorder
Binge-eating disorder is a serious eating
disorder in which person frequently
consumes unusually large amounts of food
and feel unable to stop eating.
Almost everyone overeats on occasion,
such as having seconds or thirds of a
holiday meal.
43. But for some people, excessive
overeating that feels out of control and
becomes a regular occurrence crosses
the line to binge-eating disorder.
Binge-eating disorder persons feel
embarrassed about overeating and vow
to stop. But feel such a compulsion that
one can't resist the urges and continue
binge eating.
44. Symptoms
Eating unusually large amounts of food in a specific
amount of time, such as over a two-hour period
Feeling that your eating behavior is out of control
Eating even when you're full or not hungry
Eating rapidly during binge episodes
Eating until you're uncomfortably full
Frequently eating alone or in secret
Feeling depressed, disgusted, ashamed, guilty or
upset about your eating
Frequently dieting, possibly without weight loss
45. Causes
The causes of binge-eating disorder are
unknown.
But genetics, biological factors, long-term
dieting and psychological issues increase
risk.
46. Risk Factors
Binge-eating disorder is more common in women than in
men.
Although people of any age can have binge-eating
disorder, it often begins in the late teens or early 20s.
Family history: Inherited genes increase the risk of
developing an eating disorder.
Dieting: Many people with binge-eating disorder have a
history of dieting.
Psychological issues: Many people who have binge-
eating disorder feel negatively about themselves.Triggers
for bingeing can include stress, poor body self-image and
the availability of preferred binge foods.
47. Complication
Poor quality of life
Problems functioning at work, personal life or
in social situations
Social isolation
Obesity
Medical conditions related to obesity, such as
joint problems, heart disease, type 2 diabetes,
gastroesophageal reflux disease and some
sleep-related breathing disorders
48. Psychiatric disorders that are often linked
with binge-eating disorder include:
Depression
Bipolar disorder
Anxiety
Substance use disorders
49. Treatment
Psychotherapy
Cognitive behavioral therapy
May help cope better with issues that can trigger binge-
eating episodes, such as negative feelings about your body
or a depressed mood.
Interpersonal psychotherapy
Focuses on your relationships with other people. The goal is to
improve your interpersonal skills — how you relate to others,
including family, friends and co-workers.
Dialectical behavior therapy
Helps to learn behavioral skills to tolerate stress, regulate your
emotions and improve your relationships with others, all of which
can reduce the desire to binge eat.
50. Medications
Lisdexamfetamine dimesylate (Vyvanse)
A drug for attention-deficit hyperactivity
disorder, is the first FDA-approved
medication to treat moderate to severe
binge-eating disorder in adults.
Topiramate (Topamax)
Normally used to control seizures,
topiramate has also been found to reduce
binge-eating episodes..
Antidepressants
